My husband was diagnosed with Alzheimers just about 6 weeks ago. However, I can now see that there were some symptoms earlier. The stages of Alzheimers shows that incontinence appears in the later stages of the disease. How common is it for this to be a problem already - both urinary leakage and soiling himself. He has submitted to wearing depends, but gets discouraged when he soils himself sometimes several times a day. He is 73 years old, and there has not been much problem with memory - only cognitive things such as figuring out some simple solution to a problem, and find the right words to express himself. He is on Aricept which seems to have helped the cognition somewhat. This is all new to me, so I would appreciate any thoughts anyone can give me from your own experiences.

Others will certainly know more than I do about this, but I wanted to say welcome to a forum filled with very caring and knowledgeable people.

One thing you may want to have checked is if he has a UTI. Very common and can cause a lot of problems with everything from incontinence to behavior.

Wishing you the very best.

I am so new to all this! He has been checked for urinary tract infection, and that is clear. He does have double incontinence, and this is discouraging to him. Thanks for your words of welcome and encouragement.

I'm sorry about your husband's recent diagnosis.
I don't have any answers to your question, but I wanted to say welcome to the forum.

Has your husband's incontinence just been an issue since the starting Aricept? Has it gotten worse since Aricept was started? If the answer to either of those questions is yes, you might want to ask your husband's doctor if it would be acceptible to give your husband Immodium a day.

Aricept is known for giving people the 'trots'. Immodium often helps.

Welcome and good luck.

Welcome to these boards, lazyj. One of the side effects of Aricept is diarrhea or loose stools. Perhaps his bowel incontinence is related to his Aricept. You might discuss this with his doctor.

Iris L.

Dear lazyj, welcome to these message boards.
Aricept has a side effect of diarrhea, or loose stools. Perhaps his bowel incontinence is due to a side effect of the Aricept. You can bring this up to his doctor, maybe you need to adjust the dosage.

Iris L.

Unfortunately alot of us deal with it all too often. Mom just came home from day care with filthy shoes, 2 changes of dirty clothing, etc. The aide left them outside. Usually they toss the stuff because I don't want to deal with it but it looks like mom decided to walk in it and get it all over her shoes.

This disease is just terrible...

You do want to make sure the depends are on right. Mom likes to hear hers with the pad on the hips (she wears pull ups).

aricept can cause GI upset that may be contributing to his problems, my dad had colitis and even when it was stable little insults sent him over the edge. If you LO is early in the disease then a gi work up maybe usefull. Being very regular is one thing that helps, so lots of extra fiber (like metamucil daily) helps because everything stays soft but not runny.

I'm so glad that I found this web site, and the message boards. Thanks everyone for responding. There had been a little of the incontinence before he started the Aricept, but it has gotten worse. The funny thing is that the stools are soft, not runny nor are they hard - just normal. He does eat a lot of fibre, so I don't know that metamucil or immodium would help. However it might be worth a try. I will ask the doctor next visit if he thinks the Aricept is the culprit. I asked him about the problem last visit, and he put him on flo-max though he said there was not a prostate problem. My husband thinks the flo-max helped a little, but its hard for me to tell. The doctor did say that the problem was a symptom of AD. It just seems strange to me that he is having this much of a problem with incontinence when in all other ways he seems to be in an early stage of the disease.

I tried the metamucil for 6 weeks with my mom but it did not work. It backfired and made it worse.

I just switched to immodium once a night before bedtime. She's been on it 5 weeks or so and yesterday was the first problem day that I know of.

mom is late stage and her dr and i carefully went thru her meds and side effects that are possibly bothersome to her health. the results are a healthier happier woman. i'm not saying remove the meds, but i would suggest research on side effects. the matrix i did was very helpful in making decisions. a cooperative, compassionate pcp is most important in making these decisions.

lazyj, hi, and welcome. The incontinence does seem to be starting up way too early, and way too rapidly, and that makes me very uneasy. There's something else going on here, maybe a stroke.

How experienced is his doctor in working with dementia patients? You are right, it is a symptom of dementia, but usually not until stage 6. Your husband sounds more stage 4.

I agree with vjh, a GI workup may be indicated, and possibly a visit to a geriatrician or neuro with lots of experience working with dementia. The best ones are often associated with a memory disorder clinic or AD research facility in a large research hospital or university medical center. Whereabouts do you live?

We live in Portland, OR, and there is a large university medical center here, as well as several research hospitals. I don't know about Alzheimers research centers, however. I will have to look into that. It's always difficult to suggest getting a second opinion, but I know that it has to be done sometimes, and maybe this is one of those times as his doctor has not explained things to us at all. When I asked him about this problem, he simply said that it was the AD. When I asked him if he had any doubts about his diagnosis, he said "No. What else could it be?" Not a very satisfactory answer to me. Thanks for your input.

Of all the idiotic statements... This guy does not like working with dementia patients, and couldn't care less.

There is an Alzheimer's Disease Research Center at the Oregon Health & Science University.

Jeffrey Kaye, M.D., Director
Aging and Alzheimer's Disease Center CR 131
Oregon Health and Science University
3181 SW Sam Jackson Park Road
Portland, OR 97239-3098

Website: www.ohsu.edu/research/alzheimers

Information Line: 503-494-6976

Welcome Lazyj!

We now realize that my mom had incontinence issues even before her AD diagnosis. She must have really struggled with it. You should have seen her bathroom when we got ready to clean and sell the house! Yuck. Each person advances through the stages differently. Mom always had trouble with diarrhea (we think from gall bladder removal) so we asked the Dr. about this when she was first diagnosed. He recommended Namenda over anything else because of her prior issues.

Wils' Mom, there are many things that can cause incontinence that are completely unrelated to AD, and so incontinence can start well in advance of any cognitive dysfunction. It sounds as if that's what happened with your mom. (What a mess that must have been!!! "Yuck" is the word for it!)

Usually, though, they only cause one type -- either fecal or urinary. Stroke was the first one I saw that can cause both. When it's the AD itself causing the incontinence, that typically comes very late in the disease and typically follows a pattern of urinary incontinence first. So I think lazyj would be well advised to pursue finding out if there's another reason for her husband's problems.

Thanks, JAB! I'm going to follow your advice. I'm finding not much is open this holiday weekend, but I will start first thing Monday morning. Have a good holiday!

i too am in portland oregon. mom sees a neurologist at OHSU. the hospital has been great. i would take mom to pcp there but her ins does not cover. she sees dexter at portland clinic. i like him.

do try the smoth move. i have the same problem with mom moving her stool. it soes work.

Just wondering if it could be as simple as taking LO to the bathroom on a regular basis. It seems that sometimes they just forget to go, and need their loving cargivers to remind them.

I've read that incontinence can be delayed if caregivers remind LOs to go every two hours or so.

We're (personally) not dealing with this yet, but you'd better believe I'll make sure my LO has every opportunity to handle it herself!

T

Time for an update, I think! I have so appreciated being able to read many of the postings, and have gained much in the way of info and encouragement. I have contacted a lawyer and gotten the process started for POA's, and have contacted OHSU (the University Hospital here in Portland, OR) to get the process started for an assessment. Most of my phoning has been when my husband was not in the room, as so many have mentioned it is hard to know what he is thinking about all this though he seems to be so accepting of the changes that have been made. He willingly gave up driving, and willingly accepted the necessity of wearing depends. What I was not prepared for was the overwhelming grief that hit me when the lawyer called back and I made the arrangements for the POA's. My husband happened to be sitting right there, and all he said was that it was "bound to come, and it was good to have them in place."

I know that this passive manner will probably not last, but in some ways it is heartbreaking for him to be so accepting.

Thanks for all the help and encouragement.

Your husband sounds a lot like mine (except no incontinence yet) -- very sweet, trying hard not to "be a burden" to me. (Guess how I felt when he said that!!!)

Keep in touch, let us know how both of you are doing.

Yes, JAB, I do know how you feel!!! That has been the only thing that my husband has said as far as his having AD, is that he regrets that it is going to be a burden on me.

Thank you for responding!

Lazyj: I just wanted to say that my mom has been on aricept for about three years. Last summer the incontnence started but the doctor put her on Namada and it stopped. No more wetting to bed at night and hardly any accidents during the day. It might be something to try.
I also just activated the Power of Attorny for Health. I hate making all these decisions & feel like I am taking away my mom's freedom but really she can't understand to take care of herself. Blessings to you!

Hi Lazyj, I am still new here also a couple weeks now..First off your husband is very lucky to have you..I am the oldest of 2 children and my mom is stage 6 right now..she just turned 67 in april..the incontinence is more frequent..yes her meds have been adjusted but it is also part of this disease..meds can only be adjusted so much..we all hate to face this..it is beyond sad...I not I ma not much help..I saw my mom the other day on the "potty" as they call it and it broke my heart..I pray for a cure someday..But I am also glad my sister and I can be there for my mom..so many people have no one come visit..Now that breaks my heart even more seeing someone go through this alone...stay strong and take care.

My husband is also in the early stages with Alzheimers and he also is having the same problem as your husband. His Doctor felt it was too early for this to be happening to him. He took all kinds of test. First test was a stool test which they found an infection. He was given antibiotics. But problem continued. He was given a colonoscopy which turn out fine. Also an MRI was done. That also was fine.
I then read an article in the newspaper about Irritable Bowel Movements. Restoring helpful bacteria to digestive tract is another treatment for IBM.
X-Rays, lab test,scans reveal no obnormalities. Its a difficult condition to have and to treat. Medication Rifaximin solves most problems, even though Rifaximin is use most of the time for travelers diarrhea doctors are using it for IBM patients. We don't have nothing to lose to try it.
I ask our doctor about it and he referred me to a specialist and he did prescribed it. Its a 10 day treatment. First treatment it helped some but problem continued. (He did well for 13 days.)I had read that sometimes it takes 2 or 3 treatments, so the specialist said we would repeat treatment. We did this 3 weeks later. We have completed 2nd treatment and now we have to wait for results. Today I notice stools were normal. I am praying really hard that this problem will be solved. Thought I would share this information with you. Good Luck!
Hope

LJ
One possibility is to give him only half the aricept and see if the problem lessens. (I wouldn't stop it entirely) You can report the results to the new doctors.
I believe there's now a patch that can be prescribed in place of aricept--Excelon??

Yes, brightwings is right, the Exelon patch is much less likely to cause gastrointestinal side effects, because the medicine enters the blood stream via the skin rather than the digestive tract. The biggest problem with the patch is that it can cause skin irritation, so be careful to put new patches in different places, and if a rash develops, come back to the boards to ask how others have helped alleviate this problem.

If you decide to talk to the doctor about this, please note that a recent study found that the lower-dose patch appears to be as effective as the higher-dose, and is less likely to cause adverse effects:

http://alzheimers.boomja.com/E...ne)-doses-80247.html

I'm so thankful for all the postings with regard to this problem. My husband has been on Flomax now for almost 2 months, but it is not helping. Today, we saw a neurologist at OHSU (Portland, OR) and his preliminary diag. suggests the possibility of Lewy Body Dementia, or NPH - the symptoms for either, especially the incontinence, matching more than Alzheimers. The thing that made me really wonder was that his memory is not bad at all, which would indicate early Alzheimers, but the severe (or what seems to me to be sever) incontinence shouldn't be happening yet with early Alz. He is sceduled for an MRI next Monday, then a follow up visit the first of Sept. So we will see. It will be good to get a few answers and hopefully know for sure what is going on. The doctor did mention another medicine that might help the incontinence, but we will decide that on the next visit.

For a few months now, Dad's been having loose, almost watery stools. The doctor recommended a colonoscopy, upper GI series, etc, etc. I hated to have him go through all that testing but thought they might be able to find out what's causing it and have a solution for it. But everything came back negative. I decided to go back to "square one". I changed Dad's diet-he always had sausage and fried potatoes for breakfast-but now has Activia and a bowl of cereal. It has helped some with the loose stools, but thinking about it, this all seemed to have started when he was put on Aricept! I will definitely discuss this w/the doc!
I'm new to this site and am finding yáll to be so helpful!!